@layout("/common/_form.html",{js:["/assets/btyDoubleCard/btyDoubleCard_add.js"],css:["/assets/expand/module/formSelects/formSelects-v4.css"]}){

<form class="layui-form" id="btyDoubleCardForm" lay-filter="btyDoubleCardForm">
    <div class="layui-fluid" style="padding-bottom: 75px;">
        <div class="layui-card">
            <div class="layui-card-header">基本信息</div>
            <div class="layui-card-body">
                <div class="layui-form-item layui-row">
                    <input name="id" type="hidden"/>

                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">工程店名<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="gcdm" name="gcdm" placeholder="请输入工程店名" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">妖码<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="yaoma" name="yaoma" placeholder="请输入妖码" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">营运经理<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="yyjl" name="yyjl" placeholder="请输入营运经理" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">督导<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="dd" name="dd" placeholder="请输入督导" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">法人姓名<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="frxm" name="frxm" placeholder="请输入法人姓名" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">法人身份证<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="frsfz" name="frsfz" placeholder="请输入法人身份证" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">食品经营许可证图片<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="foodBusinessLicensePic" name="foodBusinessLicensePic" placeholder="请输入食品经营许可证图片" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">食品经营许可证截止日期<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="foodBusinessLicenseDate" name="foodBusinessLicenseDate" placeholder="请输入食品经营许可证截止日期" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">营业执照图片<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="businessLicensePic" name="businessLicensePic" placeholder="请输入营业执照图片" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">营业执照名称<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="businessLicense" name="businessLicense" placeholder="请输入营业执照名称" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">营业执照地址<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="businessLicenseAddress" name="businessLicenseAddress" placeholder="请输入营业执照地址" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">统一社会信用代码<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="socialCreditCode" name="socialCreditCode" placeholder="请输入统一社会信用代码" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">状态 1未提交 2待审核 3已通过 4已驳回<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="status" name="status" placeholder="请输入状态 1未提交 2待审核 3已通过 4已驳回" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">驳回原因<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="rejectReason" name="rejectReason" placeholder="请输入驳回原因" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">工程id<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="proId" name="proId" placeholder="请输入工程id" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">营运经理电话<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="yyjlTel" name="yyjlTel" placeholder="请输入营运经理电话" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                    <div class="layui-inline layui-col-md12">
                        <label class="layui-form-label">督导电话<span style="color: red;">*</span></label>
                        <div class="layui-input-block">
                            <input id="ddTel" name="ddTel" placeholder="请输入督导电话" type="text" class="layui-input" lay-verify="required" required/>
                        </div>
                    </div>
                </div>
            </div>
        </div>
    </div>
    <div class="form-group-bottom text-center">
        <button class="layui-btn" lay-filter="btnSubmit" lay-submit>&emsp;提交&emsp;</button>
        <button type="reset" class="layui-btn layui-btn-primary" ew-event="closeDialog">&emsp;取消&emsp;</button>
    </div>

</form>

@}